The invention relates to the field of health management, particularly to an automated interactive system and method for remotely interacting across independent platforms with a group of patients with one or more disease states, and with additionally possible co-morbid conditions on a regular basis with a purpose to educate and inform the individual about his/her health condition, to motivate the individual to change health related behavior, secure compliance with medical regimens, to monitor health related parameters, and to intervene early with an ultimate view to improve the health status of the individual monitored client.
In the United States alone, over 100 million people have chronic health conditions, accounting for an estimated $700 billion in annual medical costs. Because of the continuous nature of these health conditions, and in an effort to control these medical costs, many healthcare providers have initiated outpatient or home healthcare programs for their patients. The success of these programs is dependent upon the healthcare provider's ability to effectively monitor patients remotely, and to detect and intervene at an early stage in order to prevent the patient's medical state from becoming more complicated, expensive and difficult to manage. In addition, the program's success is also dependent on its sustaining the patient's interest and continued participation in a process that often extends to the remaining term of an individual's life.
Managing a chronic disease or ongoing health condition often requires the monitoring and controlling of a physical or mental parameter relating to the health condition. Examples of these parameters include blood glucose in diabetes, respiratory flow in asthma, blood pressure in hypertension, cholesterol in cardiovascular disease, weight in eating disorders, T-cell or viral count in HIV, and frequency, severity or timing of episodes in mental health disorders.
Since the patients themselves monitor their health condition, the clinician is often limited to learning each patient's status strictly through patient initiated events, such as an emergency visit, an urgent care visit, a phone call, or other patient initiated event that results in delivery of the patient's latest medical data. Even with the current availability of remote monitoring devices that store and transmit medical data from a patient's home to a clinic, the clinician must still wait for medical information whose arrival depends on the patient's initiative.
As a result, the majority of the clinician's time is spent with the patients who are the most motivated and eager for a response, or patients whose conditions have become acute and require immediate attention, while the greatest opportunity to improve care and prevent conditions from exacerbating remain unknown and hidden with the less motivated or “pre-acute” patients who do not visit the clinician or transmit their medical data.
The less motivated patients often develop urgent medical needs that could have been prevented with prior medical management. Consequently, the cost of treating their chronic health conditions is much higher than one might expect given the sophistication of current medical monitoring devices.
In addition, the management of well motivated patients differs considerably from the strategy employed in managing high risk patients who aren't driven to initiate care because they do not perceive a crisis or are less motivated to change their behavior. Thus it is important to determine the level of motivation in the individual patient when deciding the plan of management.
A patient health status reporting system that summarizes and stratifies by risk-potential, the data received from the patients as a group would help the healthcare provider identify those patients who are in the greatest need of the provider's attention, and would help increase the provider's efficiency and productivity.
Unfortunately, most existing healthcare information systems are only designed to display medical data on an individual patient basis. Few systems have been developed that enable clinicians to view medical data for an entire group of patients simultaneously. Consequently, it is extremely difficult for a healthcare provider, such as a clinician or a nurse to prioritize his or her time and efforts in a manner that optimizes care and minimizes costs and complications for a given group of patients.
The success of a health management program in chronic health condition also depends on the program's ability to modify the health related behaviors of the patient. Examples include changing the dietary habits, and exercising habits in a patient with diabetes; smoking cessation in patients, who have suffered heart attacks, etc. A patient's compliance to medical advice varies considerably with the patient's perception of his/her health condition, healthcare provider; level of knowledge regarding his/her health condition, personal beliefs, motivational drivers, etc. In order that that the patient receives the best medical advice, and with a view to improve the ultimate prognosis of an individual with a given condition, it becomes necessary that the healthcare management plan takes into account the above factors, and that it is customized to the individual.
Notwithstanding the methods to improve the compliance in the patient, with patients on prolonged follow up, there often develops resistance to the health management plan. This resistance may develop as a result of symptom-relief in the patient and his/her consequent inability to appreciate that the underlying disease process is unchanged or may be worsening (the patient feels that he/she ‘doesn't need the medication anymore’). It may also develop in response to the nature of content presented to the individual i.e. the patient finds queries regarding a particular context intrusive to his/her lifestyle. It is important to detect resistance early and suitably modify content so as to prevent the further development of resistance, and improve compliance in the patient.
In some diseases such as asthma and allergy, and in the mental health conditions, the precise diagnosis is not always known to the healthcare provider. Further, in these conditions, even after the diagnosis is made, the best treatment is not always clear and may need to be evaluated over time. In these patients, dynamic monitoring of the patient may help understand the condition better, and formulate the ideal medical management plan in the given patient.
It is also important to determine the reliability, consistency and accuracy levels of the information that is inputted into the system, given that the future medical management of the patient is dependent on this data. This is especially more so in those cases where the data provided by the patient is the only source of information, and in the field of medical research.
Additionally, in the field of medical research, it is necessary to analyze the patient data in order to better understand patient diagnosis and needs. The system presents a method by which routinely collected data from patients over multiple healthcare facilities may be integrated and this information may be used to understand subgroups of patients who may respond differently to treatment or benefit from different treatment options. In addition, the invention also presents a method by which patients may be selected for enrollment in studies.
Further, it is also advantageous that any remote health management system be compatible with a range of communication protocols and devices, in order that the patient communicates using the media and remote apparatuses that he/she is most comfortable in using, and has ready access to. Differing remote apparatuses and communication networks have varying requirements and limitations and advantages with regard to data display and transfer. There are advantages with specific media that may be utilized in ensuring a more satisfying interaction of the patient with the healthcare provider, a greater involvement in the disease management process, and ultimately a better prognosis in the patient's disease state. Current systems are incapable of automatically optimizing content to the remote apparatus, type and speed of communication network, and to individual preferences.
Current systems are incapable of automatically administering a management plan that is relevant to patient's profile, updating the profile in response to replies received from the interaction, and highlighting to the provider those aspects of the patient's condition that require his/her greatest attention. Current systems are also incapable of risk-stratifying the individual patients within the group.
Current systems lack the capability to analyze the reliability, consistency and veracity of the replies, and validate the information inputted into the system. Further, there is no system in place that enables a researcher or a healthcare provider to select research subjects either prospectively or retrospectively for study on the basis of data contained within the profile. Current systems do not easily allow the collected data to be integrated over multiple healthcare facilities and utilized for the purpose of medical research, impeding the conduct of large multi-centric studies. Finally, current systems do not help the healthcare provider in making a diagnosis and in determining the medication and health management that is most suited to the individual patient.
This and other advantages of the invention will become apparent on consideration of the ensuing description below.